Association of exercise-induced ventricular ectopic activity with thalliummyocardial perfusion and angiographic coronary artery disease in stable, low-risk populations

This study sought to determine the association of exercise-induced ventricu lar ectopic activity with thallium perfusion defects and severity of angiog raphic coronary artery disease (CAD). Two cohorts consisting of adults with out heart failure or known severe ventricular ectopic activity at rest were studied. The first cohort consisted of adults (n = 2,743) who underwent ma ximum exercise thallium stress testing. The second cohort consisted of adul ts (n = 423) who underwent coronary angiography within 90 days of treadmill testing. Significant exercise-induced ventricular ectopic activity was def ined as frequent ventricular premature complexes or nonsustained ventricula r tachycardia. Severe CAD was defined as left main CAD (greater than or equ al to 50% stenosis), 3-vessel CAD (greater than or equal to 70% stenosis), or Ii-vessel CAD with greater than or equal to 70% stenosis of the proximal left anterior descending artery. In the thallium cohort, exercise-induced ventricular ectopic activity was associated with a greater frequency of tha llium defects (35.2% vs 18.7%, odds ratio [OR] 2.35, 95% confidence interva ls [CI] 1.62 to 3.42, p <0.001); after adjusting for possible confounders, this association persisted (for any defect adjusted OR 1.66, 95% CI 1.09 to 2.53, p = 0.02; for septal defect adjusted OR 2.77, 95% CI 1.51 to 5.07, p <0.001). There was no association between exercise-induced ventricular ect opic activity and mortality during 2 years of follow-up. In the angiographi c cohort, there was no association of exercise-induced ventricular ectopy w ith severe CAD (19% vs 20%, OR 0.93, 95% CI 0.41 to 2.09, p = NS). Exercise -induced ventricular ectopic activity was associated with a greater likelih ood of thallium perfusion defects, but was not associated with angiographic severity of coronary disease or with short-term mortality. (C) 1999 by Exc erpta Medico, Inc.